The dental profession has always assumed that dental treatment improves the quality of life of those who receive it. There is little data to support this assumption apart from studies which have evaluated social function and self-esteem and have provided some evidence that dental treatment is beneficial. However, for some frail and cognitively impaired people, dental care can be traumatic and potentially dangerous. The aim of this pilot study is to develop and test an instrument which measures physical and behavioral outcomes so as to assess the risk and benefits involved in dental treatment of a cognitively impaired person. The site for this study will be the nursing homes serviced by the geriatric mobile unit of the College of Dentistry. The study will be conducted in two phases. Phase one will assess the quality of the questions in the assessment form we have developed recruiting ten patients of record and observing them for two days before treatment and one week after treatment. The assessment form we have developed is based upon a standardized form used in nursing homes called the Minimum Data Set. The assessment form to be used will be evaluated, modified, and a further 10 patients followed for one week. After assessing the preliminary data, further changes will be made to the form. In Phase two of the study, 90 patients will be recruited and followed for 1 week. The patients will be recruited from three categories: 30 persons who receive invasive dental treatment, 30 who receive non-invasive dental treatment, and a control group of 30 similarly impaired persons who receive no treatment. The final analyses of these data will enable us to prepare a submission for a larger study which will determine predictive outcome measures of dental treatment for cognitively impaired older adults.